Vagaries of local mortality rates under the 1953-54 rules for transfer of deaths.

Abstract

An interesting and valuable feature of the Statistical Review published annually by the Registrar-General is the Table which compares the mortality of each government in England and Wales. Great care has been taken to present these comparisons in a way which discounts the effect of variations in the sex and age structure of the population. Since 1934 the method of standardization has been to multiply each crude death by an comparability factor, computed from census data, and then to divide the product by the crude death for England and Wales as a whole. The resulting figure is termed the ratio of adjusted death to the national rate (hereafter referred to as the local ratio). In the Text Volume of his 1951 Review the Registrar-General states that this procedure pro vides a valid basis of comparison between areas of mortality rates relating to deaths from all causes within the same year, except for areas whose comparability factor may be unreliable for certain years (Registrar-General, 1954). The 1953 Text Volume contains a similar statement, but adds that the method does not take account of the influence of certain types of institution, e.g. chronic sick hospitals, on the death of the area (Registrar General, 1956). The need for this additional qualification arose from a change in registration practice ordered in 1952. The new rules of procedure were set out in a memorandum circulated by the General Register Office in October, 1952, and reproduced in the Text Volume of the 1953 Review. The main provisions of the Memorandum was that persons dying on or after January 1, 1953*, in a mental hospital, mental deficiency institution, or hospital for the chronic sick were to be regarded as residents of the in which they died, whether or not they had been living